Canada, Aboriginal Communities, Governance Responsibilities, Self-Governance, Transfer of Power, Public Health Programming, Critique, Gaps
The Canadian government, and many Aboriginal communities, are committed to formally transferring varying aspects of governance responsibilities from federal hands to Aboriginal ones. These transfers take various forms, from creating Aboriginal political bodies with broad sets of governance powers, as was the case with the Nisga'a Treaty of 2000, to more partial transfers of specific powers or responsibilities, or types of responsibilities. One core transfer area is public health programming, for which there are specific and highly developed initiatives dating back to around 1989. Although it is expected that these initiatives will, overall, have very positive effects for improving the health of Aboriginal Canadians, there are many difficulties which are likely to emerge or be perpetuated under these transfers. There has been limited analysis of these difficulties to date. This paper first briefly describes the history of health transfer initiatives, and the policies which currently shape transfer agreements. After establishing this general platform, the paper then takes up the challenge of querying whether improvements to health status actually follow these forms of transferred control. The point of asking this question, as James Waldram, Ann Herring and Kue Young suggest, is not to undermine the efforts of Aboriginal communities to ameliorate their often poor living conditions, but to generate an analysis of how law, policy, and jurisdictional assignment impede or facilitate the success of such initiatives, and so gather insight into how to make improvement more likely. This paper considers some existing gaps or problems in Aboriginal public health which are likely to be perpetuated despite the transfer of control over some aspects of these problems, as well as some gaps related to health which may emerge in transfer communities. It then turns to identifying some aspects of health which are likely to improve in the coming years with increased Aboriginal control. The analysis in this paper is obviously a selective one: there are many other "gaps" which could have been included. As such, it is intended to contribute to the initiation of a broader conversation about the future of Aboriginal health under the health transfer process.
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Constance MacIntosh, "Envisioning the Future of Aboriginal Health Under the Health Transfer Process" (2008) Special Iss Health LJ 5.
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